Comparative Outcomes with an Artificial Intelligence-Powered Short Message Service Chatbot After Total Joint...

Area of Science:

• Orthopedic Surgery
• Digital Health
• Patient Outcomes

Background:

• Increasing total joint arthroplasty (TJA) volumes challenge surgeon availability for patient guidance.
• Conversational chatbots offer a scalable solution for perioperative patient engagement.
• This study evaluates the impact of a perioperative chatbot on TJA outcomes.

Purpose of the Study:

• To assess if perioperative chatbot enrollment improves outcomes after TJA.
• To compare outcomes of TJA patients using a chatbot versus a historical cohort.
• To analyze the association between chatbot use and key postoperative events.

Main Methods:

• Retrospective analysis of 1,338 TJA patients enrolled in an SMS chatbot (2020-2022).
• Comparison with a historical cohort of 1,703 TJA patients not enrolled in the chatbot.
• Analysis of emergency department visits and readmissions at 30 and 90 days postoperatively.

Main Results:

• Chatbot enrollment significantly decreased odds of 30-day (OR 0.40) and 90-day (OR 0.45) emergency department visits (p<0.0001).
• Chatbot use was associated with a significantly decreased odds ratio of 90-day readmission (OR 0.60, p=0.0168).
• These findings indicate a positive impact of perioperative chatbots on patient recovery.

Conclusions:

• Perioperative chatbot enrollment is linked to reduced emergency department visits and readmissions post-TJA.
• Chatbots represent a valuable tool for enhancing patient outcomes in total joint arthroplasty.
• This technology may improve the perioperative journey for TJA patients.